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A child with spastic cerebral palsy is to begin botulinum toxin type A (Botox) injections. Which treatment goals should the health care team set for the child related to Botox? Select all that apply.
- A. Improved nutritional status.
- B. Improved motor function.
- C. Enhanced self-esteem.
- D. Reduced caregiver strain and improved selfcare.
- E. Decreased speech impediments.
Correct Answer: B,D
Rationale: Botox injections in spastic cerebral palsy aim to reduce muscle spasticity, improving motor function and easing caregiving tasks, thus reducing caregiver strain.
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After talking with the parents of a child with Down syndrome, the nurse should help the parents establish which goal?
- A. Encouraging self-care skills in the child.
- B. Teaching the child something new each day.
- C. Encouraging more lenient behavior limits for the child.
- D. Achieving age-appropriate social skills.
Correct Answer: A
Rationale: Promoting self-care skills enhances independence and aligns with developmental goals for children with Down syndrome.
A 4-week-old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse should anticipate that the infant's vomitus would contain gastric contents and which of the following?
- A. Bile and streaks of blood.
- B. Mucus and bile.
- C. Mucus and streaks of blood.
- D. Stool and bile.
Correct Answer: C
Rationale: Pyloric stenosis causes vomiting of gastric contents, mucus, and sometimes blood due to irritation, but not bile.
Which of the following should the nurse expect to include in the plan of care for a child who is diagnosed with rheumatic fever and carditis and admitted to the hospital?
- A. Ensuring continuous parental presence at the child's bedside.
- B. Providing the child with periods of rest.
- C. Encouraging participation in age-appropriate activities.
- D. Advising the child to eat as much as possible.
Correct Answer: B
Rationale: Rest is essential in rheumatic fever with carditis to minimize cardiac workload and prevent further damage. Other options are supportive but not the priority.
A nasogastric tube is ordered to be inserted for a child with severe head trauma. Diagnostic testing reveals that the child has a basilar skull fracture. What should the nurse do next?
- A. Ask for the order to be changed to oral gastric tube.
- B. Attempt to place the tube into the duodenum.
- C. Test the gastric aspirate for blood.
- D. Use extra lubrication when inserting the nasogastric tube.
Correct Answer: A
Rationale: Basilar skull fractures contraindicate NG tube insertion due to the risk of cranial penetration; an oral gastric tube is safer.
After teaching a group of parents of preschoolers attending a well-child clinic about oral hygiene and tooth brushing, the nurse determines that the teaching has been successful when the parents state that children can begin to brush their teeth without help at which of the following ages?
- A. 3 years.
- B. 5 years.
- C. 7 years.
- D. 9 years.
Correct Answer: C
Rationale: Children can brush their teeth independently around 7 years, when fine motor skills are developed.